Healthcare Provider Details

I. General information

NPI: 1316248925
Provider Name (Legal Business Name): TENDER LOVING CARE HEALTH CARE SERVICES OF NEW ENGLAND, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 HUNT ST SUITE 102
AGAWAM MA
01001-1920
US

IV. Provider business mailing address

3854 AMERICAN WAY SUITE A
BATON ROUGE LA
70816-4013
US

V. Phone/Fax

Practice location:
  • Phone: 413-789-0027
  • Fax: 413-789-0322
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7051
License Number StateMA

VIII. Authorized Official

Name: PAUL B KUSSEROW
Title or Position: PRESIDENT
Credential:
Phone: 225-292-2031